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Different anticoagulant regimens yield equal results
Date:12/4/2007

NEW YORK, NY DECEMBER 4, 2007 Patients with acute coronary syndromes (ACS) receiving early invasive treatment including angiography and percutaneous coronary intervention (PCI) have comparable results at 1 year in terms of mortality and ischemic outcomes no matter which of three different anticoagulant regimens they are on, according to a study in the December 5 issue of the Journal of the American Medical Association.

Researchers led by Gregg W. Stone, MD, Chairman of the Cardiovascular Research Foundation in New York and Professor of Medicine and Director of Cardiovascular Research and Education at the Center for Interventional Vascular Therapy, Columbia University Medical Center, looked at over 13,000 patients with ACS (unstable angina or less severe heart attacks known as non-ST-elevation myocardial infarctions) who were given either heparin plus glycoprotein (GP) IIb/IIIa inhibitors (4,603 patients), the thrombin (blood-clotting enzyme) inhibitor bivalirudin by itself (4,612 patients), or bivalirudin plus GB IIb/IIIa inhibitors (4,604 patients).

Anticoagulant drug regimens are normally given in patients undergoing PCI to reduce the bleeding and ischemic complications that can result from these procedures. In earlier research, the same group of investigators showed that patients with ACS who received an early invasive management strategy who received bivalirudin alone experienced similar rates of ischemic complications but significantly reduced rates of major bleeding at 30 days compared with similar patients receiving bivalirudin plus GP IIb/IIIa inhibitors. As a result, less blood transfusions were required in this group of patients, and hospital costs were reduced. However, the long-term effect of bivalirudin monotherapy on composite ischemia and death are unknown.

In the short term, the optimal pharmacological regimen to support the invasive approach in ACS would ideally suppress adverse ischemic and thrombotic events whil
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Contact: Claire Laporte
claporte@crf.org
212-851-9311
Cardiovascular Research Foundation
Source:Eurekalert

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